An Update on Herbal Anti-inflammatory Agents in Periodontal Therapy

Periodontitis is the sixth-most prevalent disease in the world and the first cause for tooth loss in adults. With focus shifted to the inflammatory/immune response in the pathogenesis of periodontitis, there is a critical need to evaluate host modulatory agents. Synthetic and biological disease-modifying antirheumatic drugs are a cornerstone for the treatment of inflammatory diseases. Recent prospective cohort studies showed that synthetic disease-modifying antirheumatic drugs improved periodontal clinical parameters following nonsurgical periodontal treatment in patients with rheumatoid arthritis. Treatment with recombinant humanized monoclonal antibodies against CD20 (rituximab) and IL-6 receptor (tocilizumab), the latter also in clinical trials for the treatment of COVID-19 pneumonia, resulted in decreased periodontal inflammation and improved periodontal status. Studies on the effect of TNF-α inhibitors in patients with periodontitis yielded inconsistent results. Recent data suggest that probiotics provide anti-inflammatory clinical benefit, as do nutritional supplements, such as n-3 fatty acids, when combined with periodontal therapy. Probiotics reduce the production of proinflammatory cytokines/chemokines by suppressing NF-κB pathways and promote the accumulation of T regulatory cells. Statins, like aspirin, have been shown to exhibit anti-inflammatory and bone-preserving actions by upregulating production of Specialized Proresolving Mediators (SPMs). Currently, there is insufficient scientific support for the topical delivery of statins or bisphosphonates as adjuncts to periodontal therapy. Here, we present a critical review of the most recent host modulatory agents applied in humans and the key immune pathways that they target. Emerging evidence from novel drug candidates, including SPMs and complement inhibitors as previously studied in animal models and currently in human clinical trials, suggests future availability of adjunctive therapeutic strategies for the management of periodontitis.

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Role of Curcuma longa in the Management of Gingivitis

International Journal of Public Health Science (IJPHS) ◽

10.11591/ijphs.v7i3.14830 ◽

2018 ◽

Vol 7 (3) ◽

pp. 216

Author(s):

Umesh Pratap Verma ◽

Gupta Abhaya ◽

Sharma Disha

Keyword(s):

Pathogenic Bacteria ◽

Alveolar Bone ◽

Curcuma Longa ◽

Test Group ◽

Periodontal Therapy ◽

Gingival Tissue ◽

Tooth Surface ◽

Control Group ◽

Bleeding On Probing ◽

Anti Inflammatory

The most prevalent form of periodontal disease is gingivitis. The bleeding on probing, erythema, edema and ulceration are important signs of gingivitis. Previously conventional periodontal therapy has relied almost exclusively upon mechanical debridement of tooth surface. But as of today conventional periodontal therapy alone is not sufficient because pathogenic bacteria has been demonstrated not only in gingival tissue but even up to the crest of alveolar bone itself. Because of the side effect of non-steroidal anti-inflammatory drug, the use of medicinal plants for treatment of this disease was advocated. Amongst the herbs, Curcuma longa belonges to family Zingiberaceae, commonly available in India and used in various domestic affairs popular as Haldi. The present study has been conducted with aims to evaluate the anti-inflammatory effect of extract of Curcuma longa as topical and irrigant in various concentrations (0.5&1%) on inflamed gingival tissue of patient with gingivitis. All the subjects were divided into two groups. Group one was control, Group two (Test Group) was further subdivided in to IIa and IIb. Results revealed the extract of Curcuma longa play a significant role in reducing the inflammatory response of the gingiva like reduced gingival score, bleeding on probing and probing depth.

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Antioxidant and Anti-Inflammatory Properties of Melatonin in Patients with Type 2 Diabetes Mellitus with Periodontal Disease Under Non-Surgical Periodontal Therapy: A Double-Blind, Placebo-Controlled Trial

Diabetes Metabolic Syndrome and Obesity Targets and Therapy ◽

10.2147/dmso.s242208 ◽

2020 ◽

Vol Volume 13 ◽

pp. 753-761 ◽

Cited By ~ 4

Author(s):

Ahmad Zare Javid ◽

Seyed Ahmad Hosseini ◽

Hassan Gholinezhad ◽

Leila Moradi ◽

Mohammad Hosein Haghighi-zadeh ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Periodontal Disease ◽

Controlled Trial ◽

Periodontal Therapy ◽

Double Blind ◽

Double Blind Placebo ◽

Anti Inflammatory

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Effect of Locally Delivered Melatonin as an Adjunct to Nonsurgical Therapy on GCF Antioxidant Capacity and MMP-9 in Stage II Periodontitis Patients: A Randomized Controlled Clinical Trial

International Journal of Dentistry ◽

10.1155/2021/8840167 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Enji Ahmed ◽

Olfat G. Shaker ◽

Nermin Yussif ◽

Dalia M. Ghalwash

Keyword(s):

Clinical Trial ◽

Periodontal Therapy ◽

Enzyme Linked Immunosorbent Assay ◽

Controlled Clinical Trial ◽

Randomized Controlled Clinical Trial ◽

Randomized Controlled ◽

Nonsurgical Periodontal Therapy ◽

Grade Ii ◽

Nonsurgical Therapy ◽

Anti Inflammatory

Objectives. Periodontitis is characterized by inflammatory destruction of periodontal tissue, loss of attachment, and bone resorption. The increase in reactive oxygen species (ROS) is responsible for the oxidative damage occurring in periodontal tissues. Melatonin has important immunomodulatory, anti-inflammatory, and powerful antioxidant functions. The current study was carried out to evaluate the effect of topical melatonin gel as an adjunct to nonsurgical periodontal therapy. Methods. This split-mouth randomized controlled clinical trial was performed on 24 patients with grade II periodontitis. Two sites in each patient were randomly assigned; test sites were treated by nonsurgical therapy followed by intrapocket application of 5% melatonin gel. Control sites were treated by nonsurgical therapy followed by intrapocket application of placebo gel. Both the melatonin and placebo gel were applied weekly once for four weeks. Assessment of clinical parameters (PD and CAL) was done at baseline and 3 months after therapy. Total antioxidative capacity (TAC) and matrix metalloproteinase-9 (MMP-9) levels in GCF were also evaluated utilizing commercially available enzyme-linked immunosorbent assay kits (ELISA) at baseline and 3 months after therapy. Results. Treatment with topical melatonin was associated with a reduction in periodontal inflammation reflected as an improvement in the clinical periodontal parameters. Melatonin-treated sites showed a more statistically significant percent reduction in PD and more statistically significant percent gain in CAL than the control site. Additionally, a significant increase in TAC and a significant decrease in MMP-9 levels in GCF were found in melatonin-treated sites in comparison to control sites. Conclusions. The adjunctive use of topical melatonin gel with nonsurgical periodontal therapy has potent anti-inflammatory and antioxidant activity in the treatment of grade II periodontitis patients.

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